"[T]he legal obligation to provide compliant COBRA notices ultimately rests with the plan administrator, not the COBRA vendor.... Common issues include vague or incomplete election instructions, no reference to the name of the plan, missing deadlines, or unclear premium information. These deficiencies are often discovered only after a participant challenges the notice, at which point it is too late to correct the problem without consequences."  MORE >>

"Although many plan obligations are tied either to the calendar year or the plan year, there are two [ACA] items that arise 'off cycle' during the summer months: the Patient-Centered Outcomes Research Institute (PCORI) Fee and Medical Loss Ratio (MLR) rebates."  MORE >>

"CMS is seeking input on key provisions of the Medicare Part D PBM reforms enacted earlier this year, including the upcoming 'delinking' requirements and new PBM data reporting obligations scheduled to take effect in 2028.... CMS is now seeking stakeholder input on several foundational questions ... The answers to these questions could have a substantial impact on how PBMs structure contracts, how affiliated entities are treated and how revenue streams are evaluated in the future."  MORE >>

"For employers, the same analysis reaches self-insured group health plans. AI tools introduced by a TPA, PBM, or wellness vendor that touch plan PHI implicate the plan sponsor's HIPAA obligations and its vendor oversight duties."  MORE >>

"Virginia ... [has enacted] a law establishing a mandatory paid family and medical leave (PFML) insurance program. By October 1, 2027 (and annually thereafter), the Virginia Employment Commission will set the contribution rate, based on wages and capped at the Social Security taxable wage base. Contributions -- evenly split between employers and employees, with an exception for certain small employers -- will start on April 1, 2028. Benefits will first become available on December 1, 2028."  MORE >>

"Express Scripts' lawsuit seeks to prevent the implementation of the law and preserve its ability to continue operating under its current business model. While the legal arguments will be addressed by the courts, the lawsuit itself raises an important question: Why are PBMs willing to spend significant resources challenging laws designed to separate PBM functions from pharmacy ownership? The answer may lie in the tremendous value that vertical integration provides to large PBM organizations." [Express Scripts, Inc. v. Blane, No. 26-9999 (M.D. Tenn. complaint filed Jun. 6, 2026)]  MORE >>

"The complaints ... mark the latest escalation in the legal battle over state efforts to regulate PBMs.... The litigation also underscores a growing conflict between states seeking to reshape the prescription drug marketplace and PBMs arguing that federal law preempts many of those reforms." [Pharmaceutical Care Mgmt. Ass'n (PCMA) v. Gillespie, No. 25-3200 (C.D. Ill. complaint filed Jun. 16, 2026); Pharmaceutical Care Mgmt. Ass'n (PCMA) v. Blane, No. 25-0816 (M.D. Tenn. complaint filed Jun. 15, 2026)]  MORE >>

"Employers that are now receiving settlement proceeds should be aware that they may have fiduciary duties under ERISA with respect to the use of any proceeds from the settlement fund.... Unless specific guidance is issued related to the BCBSA settlement, employers may want to use the [the DOL's prior MLR guidance] as a reference when determining how to calculate what portion of the BCBSA settlement proceeds should be considered 'plan assets,' and how those funds can be used."  MORE >>

"[1] Not filing when a filing is required ... [2] Inaccurate or inconsistent participant counts ... [3] Missing or incomplete Schedule A ... [4] Misapplying Schedule C requirements ... [5] Filing late without using an extension ... [6] Incorrect plan characteristic codes."  MORE >>

"Employers are used to getting very little visibility from fully insured plans. When they're considering self-funding, they want to know that this time will be different. The answer ... [is] a combination of tools and capabilities working together: [1] Employer reporting that shows the financial picture. [2] Engagement and utilization data that reveals how the plan is being used. [3] Chronic care coordination that tracks how ongoing conditions are managed. [4] Patient outcome metrics that measure real health improvement. [5] Cost savings analysis that ties it all back to dollars."  MORE >>

"This essay collection examines how rising obesity prevalence affects future mortality, highlighting obesity-related diseases, severe obesity trends, weight-loss interventions, GLP-1 medications, alternative obesity measures, and actuarial implications for mortality forecasting, insurance pricing, underwriting, and public health planning."  MORE >>

"[A] healthy 65-year-old couple retiring this year will need to save on average: [1] $418,000 under Original Medicare with Medigap Plan G plus Part D coverage, an increase of $30,000 (+7.7%) from 2025. The couple is projected to spend an average of $637,000 on healthcare expenses over the course of their remaining lifetime. [2] $211,000 with Medicare Advantage plus Part D (MAPD), an increase of $28,000 (+15.3%) from 2025. The couple is projected to spend an average of $320,000 on healthcare expenses over the course of their remaining lifetime."  MORE >>